Circulating levels of cytokines during pregnancy: thrombopoietin is elevated in miscarriage
Received 21 February 2007; received in revised form 17 May 2007; accepted 23 May 2007. published online 14 August 2007.
Objective
To evaluate the hypothesis that cytokine levels are associated with miscarriage risk using serum samples collected before report of miscarriage.
Design
A nested case-control study.
Setting
Biospecimens from the multisite Collaborative Perinatal Project, University of Florida, laboratory assessment of interleukin (IL)-1 receptor antagonist, IL-1β, IL-4, IL-6, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, thrombopoietin (TPO), and granulocyte colony-stimulating factor (G-CSF).
Patient(s)
Cases of miscarriage (n = 439) were matched to controls (n = 373) by gestational age at sample collection.
Intervention(s)
None.
Main Outcome Measure(s)
Miscarriage.
Result(s)
Increased risk of miscarriage was associated with elevated TPO (adjusted odds ratio [OR] 1.16, 95% confidence interval [CI] 1.00–1.36) and decreased G-CSF (adjusted OR 0.78, 95% CI 0.64–0.95). When analysis was restricted to samples collected more than 35 days before miscarriage, the effect of G-CSF was not observed (adjusted OR 0.96, 95% CI 0.72–1.28), whereas increased risk related to higher TPO remained.
Conclusion(s)
Circulating levels of TPO may be associated with increased risk of miscarriage.
aEpidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Insttutes of Health, Bethesda, Maryland
bDepartment of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland
cDepartment of Obstetrics and Gynecology, University of Florida, Gainsville, Florida
Reprint requests: Enrique F. Schisterman, Ph.D., Epidemiology Branch, DESPR, National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd., Rm. 7B03, Rockville, MD 20852 (FAX: 301-402-2084).
Funded by an intramural grant from the Epidemiology Branch of the Division of Epidemiology, Statistics and Prevention Research at the National Institute of Child Health and Human Development.
ABSTRACT